HISTOLOGY - LABORATORY

S.Y. ‘23 - ‘24 | MEDICAL LABORATORY SCIENCE | MIDTERMS WEEK #3: URINALYSIS

– 2ND SEM MIDTERMS WEEK #3 – 5.0 SAMPLE CONTAINER

1.0 URINALYSIS
● Clean and dry
● Aids in the diagnosis of disease ● Should be clear or translucent disposable
● Screens asymptomatic populations for material (to assess color, clarity and volume)
undetected disorders ● 50 to 100 mL capacity
● Monitor the progress of disease and the ● With lid or cover that is easily placed or
effectiveness of therapy removed
● Must be labeled before or immediately after
2.0 Why do we need to examine urine? collection
- Label is always placed directly on the
● Yields so much information container holding the specimen
● Aids in diagnosis of symptoms Note: 10-15mL of urine (Average: 12mL)
● Gives enough information about the
physiology and structure of kidneys and
6.0 URINE SPECIMEN REJECTION
urinary tract
Note: Urine is the ultrafiltrate of plasma ● Unlabeled urine specimen container
● Mislabeled urine specimen container
3.0 SPECIMEN TYPE ● Names on container and order slip do not
match
● Visibly contaminated urine (e.g., fecal material,
toilet tissue, etc.)
3.1 Random
● Insufficient volume of urine for test(s)
● Collected at any time requested
● Used for routine screening
7.0 PHYSICAL EXAMINATION
3.2 First-morning Urine ● Gives preliminary information
● Urine voided after sleep ● Correlation with chemical and microscopic
results
● Examines the color, clarity, volume, and
3.3 Timed specific gravity
● Collect all urine during specific time interval
(e.g.,24-hr or 12-hr) 7.1 Color
● Examine the specimen under a good light
4.0 COLLECTION TECHNIQUE
source, looking down through the container
against a white background
● Normal color: Yellow
4.1 Random Catch ● Different color ranges from:
● No preparation before collection Colorless - Amber - Orange - Red Green - Blue -
Brown - Black
● Normal Variations:
4.2 Midstream Clean Catch - Normal metabolic function
● Genital area is cleansed before collection - Physical activity
- Ingested material
- Drug intake
4.3 Other Collection Techniques ● Abnormalities:
● Catheterized, urethral (lower) - Bleeding
● Catheterized, ureter (upper) - Liver disease
● Suprapubic aspiration (done by physician) - Infection
● Pediatric collection bag Additional Information:
● Urochrome:
- Responsible for yellow color of urine
- Proportional to metabolic rates

PPT | LECTURE HISTOLOGY - LAB | MIDTERMS PAGE 1

Tresha Mae Y. Natad, fRMT
 HISTOLOGY - LABORATORY
S.Y. ‘23 - ‘24 | MEDICAL LABORATORY SCIENCE | MIDTERMS WEEK #3: URINALYSIS

● Urobilinogen/Urobilin: Reasons for Turbidity

- Orange to brown color NON-PATHOLOGIC:
- Breakdown product of RBCs ● Fecal contamination
● Uroerythrin: ● Vaginal cream
- Pink color ● Squamous epithelial cells
- Attaches to amorphous material ● Amorphous material
● Talcum powder
● Semen
COMMONLY OBSERVED ABNORMAL COLORS
● Mucus
● Radiographic media
POSSIBLE CAUSES / INDICATION
PATHOLOGIC:
STRAW Normal ● Abdominal crystals
YELLOW ● Lymph
● Lipids
DARK Concentrated specimen ● Cells
YELLOW
7.3 Specific Gravity
RED Menstruation (blood), myoglobin,
hemoglobin, beets, rifampin ● Normal range: 1.003 to 1.035
● Isosthenuric: 1.010
YELLOW / Bilirubin ● Hyposthenuric: below 1.010
ORANGE ● Hypersthenuric: above 1.010
● 1.000 = water
GREEN Pseudomonas aeruginosa infection

BLUE Indicanuria 7.4 Odor

● Seldom of clinical significance and is not a
BLUE GREEN Clorets, methylene blue part of the routine analysis
● Freshly voided has a FAINT AROMATIC color
BROWN Oxidation of hemoglobin

BLACK Homogenetestic acid, melanin ODOR REASON DISEASE

Ammoniacal Old specimen, UTI

7.2 Clarity bacterial
composition
● Refers to the transparency or turbidity of a
urine specimen Fruit Odor Ketones DM
● Describes the overall appearance of a urine
specimen Maple Syrup Presence of Maple syrup urine
● Essentially clear, cloudy urine does not branched chain
necessarily indicate pathologic amino acids
● Clarity is affected by particulate matters in Sx.
Mousy Odor Phenylalanine Phenylketonuria
CLEAR Transparent Mercaptan Ingestion of Isovaleric
Odor asparagus, acidemia
HAZY Print easily seen through urine
garlic, eggs
CLOUDY Print blurred through urine
Fecaloid Recto-visical Methionine-Mala
Odor fistula
TURBID Print cannot be seen through urine
Sweaty Feet Isovaleric acid Isovaleric
MILKY May precipitate or be clotted
acidemia

Cabbage Methionine Methionine

PPT | LECTURE HISTOLOGY - LAB | MIDTERMS PAGE 2

Tresha Mae Y. Natad, fRMT
 HISTOLOGY - LABORATORY
S.Y. ‘23 - ‘24 | MEDICAL LABORATORY SCIENCE | MIDTERMS WEEK #3: URINALYSIS

malabsorption Blood 30 seconds

Rotting Fish Trimethylamine Trimethylaminuria Leukocyte 120 seconds

Esterase
Rancid Tyrosine Tyrosinemia

Sulfur Odor Amino acids Cystinuria, 9.0 MICROSCOPIC EXAMINATION

Cystinosis,
Homocystinuria
8.0 CHEMICAL EXAMINATION
● Examines the pH, glucose, albumin, specific
gravity, blood, ketone, nitrite, bilirubin,
leukocyte esterase, protein, and ascorbic acid
● Examine the presence of cells, casts, crystals
● Specific volume: transfer well-mixed urine to a
10-15mL test tube
● Centrifugation: 5 minutes at RCF at 400
● Decantation: remaining urine and sediment
recommended volume is 0.5 to 1mL
● Microscopy: place a drop of urine on clean
slide with cover slip

8.1 Reagent Strip Technique Reference Intervals for Microscopic Examination

● pH: aids in determining the existence of
Component Number Magnification
systemic acid-base disorders of metabolic or
respiratory origin Red blood cells 0-3 Per HPF
● Protein: indicative of early renal disease
● Glucose: tubular transport of glucose has White blood cells 0-8 Per HPF
reached its renal threshold and glucose
appears in the urine Casts 0-2 Per LPF
Additional Information: hyaline
- Used to perform the routine chemical tests on for finely
urine granular
- Strips consist of chemical-impregnated
absorbent pads on a plastic strip Epithelial Cells:
- Several degrees of colors are shown to provide ● Squamous Few Per LPF
semiquantitative readings of NEG (-), Trace: ● Transitional Few Per HPF
1+, 2+, 3+, 4+ (increase in glucose: look for ● Renal Few (0-1) Per HPF
yeast)
- Estimate of mg/dL are also provided for many Bacteria and yeast Negative Per HPF
of the test areas
Abnormal crystals None Per LPF
PARAMETERS REACTION TIME
Amorphous:
pH ● URATE: acidic pH = pink sediment
● PHOSPHATE: alkaline pH = white sediment
Protein

Bilirubin 60 seconds
SPECIMEN PREPARATION
● Examine when fresh or preserved
Urobilinogen ● RBCs, WBCs, casts, lysed in dilute, alkaline
urine
Nitrite ● Refrigeration precipitates crystals
● Less contamination (epithelial cells) from
Ketone 40 seconds midstream clean-catch specimens, collected
through midstream clean catch method
Specific Gravity 45 seconds

Glucose 30 seconds

PPT | LECTURE HISTOLOGY - LAB | MIDTERMS PAGE 3

Tresha Mae Y. Natad, fRMT